Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Dermatology Service, Memorial Sloan Kettering, New York, New York, USA.
Skin Res Technol. 2022 Jul;28(4):623-632. doi: 10.1111/srt.13163. Epub 2022 Jun 2.
The rapid adoption of digital skin imaging applications has increased the utilization of smartphone-acquired images in dermatology. While this has enormous potential for scaling the assessment of concerning skin lesions, the insufficient quality of many consumer/patient-taken images can undermine clinical accuracy and potentially harm patients due to lack of diagnostic interpretability. We aim to characterize the current state of digital skin imaging applications and comprehensively assess how image acquisition features address image quality.
Publicly discoverable mobile, web, and desktop-based skin imaging applications, identified through keyword searches in mobile app stores, Google Search queries, previous teledermatology studies, and expert recommendations were independently assessed by three reviewers. Applications were categorized by primary audience (consumer-facing, nonhospital-based practice, or enterprise/health system), function (education, store-and-forward teledermatology, live-interactive teledermatology, electronic medical record adjunct/clinical imaging storage, or clinical triage), in-app connection to a healthcare provider (yes or no), and user type (patient, provider, or both).
Just over half (57%) of 191 included skin imaging applications had at least one of 14 image acquisition technique features. Those that were consumer-facing, intended for educational use, and designed for both patient and physician users had significantly greater feature richness (p < 0.05). The most common feature was the inclusion of text-based imaging tips, followed by the requirement to submit multiple images and body area matching.
Very few skin imaging applications included more than one image acquisition technique feature. Feature richness varied significantly by audience, function, and user categories. Users of digital dermatology tools should consider which applications have standardized features that improve image quality.
数字皮肤成像应用的快速采用增加了智能手机获取图像在皮肤病学中的应用。虽然这对于扩大对可疑皮肤病变的评估具有巨大潜力，但许多消费者/患者拍摄的图像质量不足会降低临床准确性，并由于缺乏诊断可解释性而对患者造成潜在危害。我们旨在描述数字皮肤成像应用的现状，并全面评估图像采集功能如何解决图像质量问题。
通过在移动应用商店、谷歌搜索查询、以前的远程皮肤病学研究和专家推荐中进行关键字搜索，独立评估了三位评审员发现的公开可发现的移动、网络和桌面皮肤成像应用程序。应用程序按主要受众（面向消费者、非医院实践或企业/医疗系统）、功能（教育、存储和转发远程皮肤病学、实时互动远程皮肤病学、电子病历附加/临床成像存储或临床分诊）、应用内与医疗保健提供者的连接（是或否）和用户类型（患者、提供者或两者兼有）进行分类。
在 191 个包含皮肤成像应用程序中，略多于一半（57%）具有 14 种图像采集技术特征中的至少一种。那些面向消费者、旨在用于教育目的且为患者和医生用户设计的应用程序具有明显更丰富的功能（p<0.05）。最常见的功能是包含基于文本的成像提示，其次是需要提交多张图像和身体区域匹配。
很少有皮肤成像应用程序包含超过一种图像采集技术特征。功能丰富度因受众、功能和用户类别而异。数字皮肤病学工具的用户应考虑哪些应用程序具有标准化的功能可提高图像质量。
